title: Self-perceived met and unmet care needs of frail older adults in primary care.
abstract: In order to provide adequate care for frail older adults in primary care it is essential to have insight into their care needs. Our aim was to describe the met and unmet care needs as perceived by frail older adults using a multi-dimensional needs assessment, and to explore their associations with socio-demographic and health-related characteristics. Cross-sectional baseline data were used from the Frail older Adults: Care in Transition (ACT) study in the Netherlands, consisting of 1137 community dwelling frail older adults aged 65 and above. Patients were recruited through 35 primary care practices. Self-perceived care needs were assessed using the Camberwell Assessment of Need for the Elderly (CANE). Socio-demographic characteristics included age, sex, partner status and educational level. Health-related characteristics included functional capacity, hospital admissions, chronic diseases and the degree of frailty. Frail older adults reported on average 4.2 care needs out of 13 CANE topics, of which 0.5 were unmet. The physical and environmental domain constituted the highest number of needs, but these were mostly met. Unmet needs were mainly found in the psychosocial domain. Regression analyses revealed that Activities of Daily Living (ADL) limitations and a higher frailty score were the most important determinants of both met and unmet care needs. A younger age and a higher educational level were associated with the presence of unmet care needs. In conclusion, most frail older adults in primary care report to receive sufficient help for their physical needs. More attention should be paid to their psychosocial needs.
authors.affiliation: Department of General Practice & Elderly Care Medicine, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: e.hoogendijk@vumc.nl.
authors.forename: Emiel O
authors.initials: EO
authors.lastname: Hoogendijk
authors.forename: Maaike E
authors.initials: ME
authors.lastname: Muntinga
authors.forename: Karen M
authors.initials: KM
authors.lastname: van Leeuwen
authors.forename: Henriëtte E
authors.initials: HE
authors.lastname: van der Horst
authors.forename: Dorly J H
authors.initials: DJ
authors.lastname: Deeg
authors.forename: Dinnus H M
authors.initials: DH
authors.lastname: Frijters
authors.forename: Lotte A H
authors.initials: LA
authors.lastname: Hermsen
authors.forename: Aaltje P D
authors.initials: AP
authors.lastname: Jansen
authors.forename: Giel
authors.initials: G
authors.lastname: Nijpels
authors.forename: Hein P J
authors.initials: HP
authors.lastname: van Hout
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000379:methods*; D006301:Health Services Needs and Demand; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D020380:Needs Assessment / Q000706:statistics & numerical data*; D010465:Perception; D011320:Primary Health Care / Q000379:methods*
keywords: Care needs; Frailty; Needs assessment; Older people; Primary care